Complaints against Limpopo’s health MEC are beginning to stack up. Unsurprisingly, Limpopo health MEC Phophi Ramathuba failed to honour a commitment to be interviewed. Initially, Ramathuba’s spokesperson, Neil Shikwambana, indicated that Ramathuba could fit in a 30-minute conversation with Daily Maverick via Zoom last Friday. Shikwambana then postponed the interview and, over the next four days, stopped responding to messages and phone calls.

Accounts by other journalists who have tried to contact Ramathuba since she took over as MEC in 2015 show that this is not unusual. Issues where her responses have been scant at best include dodgy aeromedical contracts in the province and the attempted closure of ARV-distributing non-governmental organisation, the Ndlovu Care Group. When she is in the news, it’s usually for the wrong reasons.

Ramathuba is based in Polokwane, where she was elected to the ANC’s provincial executive committee in 2014. She leads a busy life, according to her Facebook page, with a constant stream of official engagements.

However, these crumbs of curated efficiency fall far short of the accountability expected of a top provincial executive. The fact is, Ramathuba has grown adept at ghosting journalists, opposition parties, and the public at large.

Let’s define ghosting as a relationship marked by an inexplicable absence of communication from one side. The irony here is that the relationship in question is between the “public” and a “public servant”. A relationship based on firm rules. 

We (the public) pay Ramathuba R2-million a year (the Government Gazette lists MEC cash packages at R1,977,785, excluding perks) to manage Limpopo’s health system which caters for the province’s six million residents. 

She is entrusted with billions of tax rands: Limpopo’s health allocation was R20.8-billion in 2019/20; with R22-billion earmarked for 2020/21 and R23.8-billion for 2021/22. 

Central to this process is the requirement that she keeps the public informed – and this feedback is not meant to be provided solely on her terms.

It is noteworthy that Limpopo’s health department lists “transparency” as one of its core values. “All our services will be transparent,” notes its official website. 

Waiting for a response

In keeping with her flair for non-accountability, Ramathuba did not respond to urgent questions relating to Covid-19 tabled by the Democratic Alliance last week. 

In a letter dated 6 April, the DA’s spokesperson on health in Limpopo, Risham Maharaj, asked that the province’s health portfolio committee have a virtual meeting to “critically analyse the effectiveness of the strategy being used at this time” and to “receive verbal or written feedback from the minister.” 

It lists seven points of concern, including readiness of the province’s quarantine sites to receive Covid-19 patients. Speaking to Daily Maverick on Tuesday, Maharaj said that, eight days later, they had still not received an acknowledgement or response from Ramathuba’s department.

This comes at a time when the Limpopo health department’s Covid-19 “strategy” is under close scrutiny, after two medical doctors were detained like criminals at their house in Modimolle on 31 March. The two women, who work at Mmametlhake Hospital in Mpumalanga, tested positive for Covid-19 on 29 March. 

They had been adhering to strict self-isolation regulations at their home when a health official and police officers wearing masks arrived on their doorstep at night, with a court order issued in favour of Ramathuba. The doctors reported how they were locked in small rooms at state-funded quarantine site, the Modimolle MDR-TB Hospital, without medical care, sufficient food or toilet paper. They were later released after approaching the courts.

In a telephone conversation, Maharaj voiced his frustration: “The department [of health] is holding everything very close to its chest. It is frustrating. All this should be public knowledge. We’ve had no briefings. She [Ramathuba] misled us regarding the province’s state of readiness. I told her she needs to be transparent, and she took offence to this. She is very defensive. She is arrogant as an MEC. 

“In my opinion, the department of health is the worst run department in the province. The wage bill for the department is really high, leaving very little for equipment and infrastructure. Yet hospitals are understaffed, with lots of vacancies. This is because some people are appointed at maximum salaries – classic cronyism. In addition, medical negligence claims in the hospitals are very high; we want to know why and what action is being taken.”

In a letter addressed to Ramathuba dated 2 April, South African Medical Association (SAMA) chairperson Dr Angelique Coetzee condemned the treatment of the two Modimolle doctors. 

 “We are disappointed in the approach you and the Limpopo Department of Health have taken regarding these doctors,” she writes. “We believe it to be heavy-handed, unfair, and contrary to the provisions which national government has stipulated. We further believe that you are politicising the events for political gain; a truly troubling development.” 

Ramathuba evidently took offence to Coetzee’s letter. On 3 April, Limpopo’s health department released a statement accusing Coetzee of being “malicious” and of spearheading “a crusade to misrepresent the department’s stance”. The statement noted: “As the department, we find it to be extremely petty for SAMA to utilise uncorroborated innuendos attributed to the MEC in order to attack the person of the MEC.”

This public altercation is even more bizarre given Ramathuba’s long term links to SAMA. A founding member of the South African Medical Association Trade Union (SAMATU), Ramathuba served on SAMA’s board for over a decade.

Once a strident public health activist, Ramathuba was known to slam national and provincial health departments for lacking patient care, medicine availability or non­-payment of doctors’ salaries. In a spectacular 180-degree turn, she now seemingly embodies the very attitudes and shortcomings she once sought to publicly eradicate.  

Stones start flying

After Ramathuba’s surprise political rise to MEC, then national Minister of Health Dr Aaron Motsoaledi quipped to her: “You’re going from throwing stones to catching them.”

Despite Ramathuba’s trade union background, several unions are now calling for her dismissal. In February, under the banner #PhophiMustGo, the Young Nurses Indaba Trade Union (YNITU) called for Ramathuba’s resignation saying she is “incompetent” and “causing havoc in Limpopo provincial health”. They cited a crumbling public health system where women have been left to give birth unattended. Limpopo’s health department dismissed these claims as “unfortunate and irresponsible”, the SABC reported. 

Ramathuba is active on Twitter too, where her feed is a mix of generic healthcare announcements, accolades for healthcare workers, and retweeted compliments. On 23 March she retweeted an admirer saying: “I know she is not other people’s favourite, but @PhophiRamathuba is on message.” 

 In 2018, Ramathuba sparked a landslide of criticism for public comments and tweets inferring that HIV/Aids is a “black disease”, and that people living with HIV/Aids have themselves to blame for getting infected. While she said the widely condemned tweets and comments had been taken out of context, her department did issue an apology to the South African Human Rights Commission.

Raised in Mashamba village in Vhembe, Ramathuba was one of five children born to teacher parents. It was her aunt – a nurse – who inspired her to become a doctor.

In 2016, Ramathuba opened up about her formative years in a rare in-depth interview with community newspaper, Bosveld Review. “As a child, I used to admire my aunt in her nursing uniform,” said Ramathuba. “My aunt used to take me with her to the nurses home in Elim. That is where my passion for healthcare started. I love working with people and the reward of my work is seeing someone’s life improve due to the service I have given them.”

Ramathuba’s academic qualifications include a Bachelor of Medicine and Bachelor of Surgery degree from the Sefako Makgatho School of Health Sciences (formerly Medunsa) and a Master’s degree in medical pharmacology from the University of Pretoria; with additional health management and business leadership courses. She cut her teeth as an intern at Mokopane Hospital, working her way up to chief executive at Voortrekker Hospital, before veering into politics. 

Ramathuba, a mother of two teenage daughters, told Bosveld Review that in her spare time she enjoys listening to gospel music, reading, cooking, game drives, and trying on shoes.

“I would often book into a game lodge just so I could go on game drives,” she said. “I also have a love for shoes. A girl can never have too many shoes. I don’t have a lot of time to spend shopping and trying on clothes. It is an added bonus that shoes are so easy and quick to fit. Because of that they suit my busy schedule perfectly.”

With luck, Ramathuba might find time in her schedule to recover her misplaced accountability. After all, the world is in the middle of a pandemic; South Africa’s northernmost province is not exempt and deserves a combined strategic effort over ego politics. DM/MC